Report: Many Fraud Safeguards Exist for Social Security Disability Program

More and more often we hear about how Social Security Disability Insurance fraud is running rampant. While there is some fraud that exists in any government benefits program, this allegation is far from the truth, and a recent article from the Huffington Post takes a look at some of the safeguards in place to prevent fraud from occurring.

The first safeguard against fraud is strict eligibility standards. There are many requirements to qualify for Social Security Disability Insurance (SSDI) benefits. One of the first requirements is that claimant must have a substantial work history.

As our Boston disability insurance benefits attorneys can explain, the work history requirement is established in terms of quarters worked prior to becoming disabled. The number of quarters required depends on the age of the claimant at time of disability. For example, a 21-year-old claimant would not be required to have the same work history as a 38-year-old claimant, in most cases.

The reason for this work history requirement is because Social Security Disability Insurance (SSDI) works much like a private insurance policy, as the name would imply. When you work the requisite number of quarters and earn quarterly credits, the money being withheld from your paycheck each month is being considered your premium to have SSDI coverage. If you haven’t worked long enough to earn the requisite number of quarterly credits, then you haven’t paid your premium, and you probably would not qualify for benefits. This is a major fraud prevention measure. In reality, only around 40 percent of applicants qualify for benefits, and there is no credible evidence to support claims that these people are healthy enough to be working.

Another safeguard against disability benefits fraud mentioned in the article is the agency’s own quality control review process. Before any benefits are paid, every decision by staff or an administrative law judge (ALJ) is reviewed to make sure the beneficiary qualifies. However, it should be noted, through this quality control process, the SSA is much more interested in saving money than they are about making sure claimants are satisfied with the process. This makes sense, since the review process is considered to be a safeguard against disability benefits fraud.

Another fraud safeguard is a review of benefits payment accuracy. The agency is constantly looking for any overpayments, meaning benefits paid that should not have been paid, and the rate of accidental overpayment is actually less than one percent. It should also be noted, the majority payments do not come from fraud, but in problems in communications with benefit recipients. Of that one percent overpayment, the agency has been able to recover around 85 percent of these payments, and less than 15 percent of the one percent of overpayments were written off as a loss.

In addition to quality checks before benefits are awarded, there are continuing reviews to make sure people have not recovered from their disability and are still collecting benefits. It is important note, however, that very few of those on disability benefits are actually able to recover to the point where they can go back to work.

If you or a loved one is seeking Social Security Disability Insurance benefits in Boston, call for a free and confidential appointment at 1-888-367-2900.